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MARION COUNTY BUILDING INSPECTION <br />SENATOR BLDG, NO, 225 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4:30 <br /> 24 HOUR CODE-A-PHONE: 588-7904 <br /> <br /> I am performi~ work on a prol3erty; own or occupy <br /> l am a registered builder OR ( )theauthorizedrepresentatlve <br /> of a registered builder, <br /> The work will be performed by a registered builder, <br /> Other <br /> I have read and agree to the terms stated on the reverse aide of <br /> this document. <br />OAI'E: 06/04./92 'r.f, ME: 13:27:48 <br /> <br /> 220 YEW C'r -- 2~ <br />AUP~VtLLE OR 97325 j'8~r4f~'~Ef"ai'f'¢; ~'i~§i, ~aba~AN~ gOAD; <br /> <br /> ~UFACTURED ST~CTURE <br /> <br /> E~E~RE~ ~ PARK <br /> <br />AU~VJLLE OR 97325 " ...................................... <br />~E= ?49-2?65 <br /> S~TE NU~ER: 92-02119 <br /> <br /> 26 ~ <br /> <br />TYPE** NANUFAC'FURED ,~5'TRUCTURE PE~41T OR APPLiCATiON NO.' 9040415 <br /> <br />CONTRACTOR, NO. 30094 <br /> INTERO J. 'TY SALES <br />3:3213 SE HWY 34 <br />A~Y, 97321 <br />~E: 926-8844 <br /> <br />IvIAC4UFACTURED STRUCTURE PLACEMET, I'r/OONNEC'f'irON <br />i'4ANUFACTURED STRUCTURE STATE FEE <br />?4ANUFAO'TURED STRUCTURE sS'rATE ,~:~JRCHARGE <br /> <br />I'OTAL A:%~E,,'55EB FEES <br />PREVIOUS RE~EiP'FS <br />THIS RECEIPT <br /> <br />Q~dANI'II'Y AMOUNT <br /> $182~00 <br /> $20.00 <br /> $9.1o <br /> <br />$211.10 <br /> $o~oo <br />$211.10 <br /> <br /> . BAI,~CE DUE $0.00 <br />PAYEE: NADiNE RUTH fRUMp ,~ tNvntn¢ <br />RECEIVED BY. Pi3 ~/// 'TYPE- IN CHECK ~ <br /> <br />INFORMATION HA~ B~EN PROVIDED. TH~ APPLICANT TO AE~iI.IRE THAT ALL NECIE~5~ARY <br /> <br />SEPTIC: BY ..................................... OAt'E .................................... CiTY JURISDiC'I'iON: BY .......................... DATE <br />ZONING: 8Y DATE S~'[~ACKS: FR 10 LS t5 R~ 35 RR 15 SP <br />REI~S, RKS: MOBIBE-"ROfCIE PLACERE~T ......... ' .................. <br /> <br />PLANNING ACTION: <br /> <br /> OFFICE COPY <br />FORM # MO 15-56 REV. 4/9O <br /> <br /> <br />